1. © The Status Of Acute Osteomyelitis In Sickle Cell Disease - A 15- Year Review Sadat-Ali, M EDIZIONI MINERVA MEDICA, INTERNATIONAL SURGERY; pp: 84-87; Vol: 83 King Fahd University of Petroleum & Minerals http://www.kfupm.edu.sa Summary Background. This 15-year review presents the status of acute osteomyelitis in sickle cell disease so as to assess the type of infection, infecting organism, mode of treatment and complications. Design. Retrospective analysis of patients seen in the last fifteen years. Setting. King Fahd Hospital of the University at Al-Khobar and College of Medicine and Medical Sciences, King Faisal University, Dammam, Saudi Arabia. Results. Two-hundred and one patients were treated for acute osteomyelitis in sickle cell disease. These patients had 327 episodes. There were 125 males and 76 females with a mean age of 9.6 years (range 6 months to 33 years), Forty-eight (23.8%) patients had multifocal infection. The most common infecting organism was salmonella species in 84 patients (41.7%) and 71/84 patients were below the age of 12 years. In 39/45 patients who as children grew salmonella species initially had acute osteomyelitis due to other organisms in adult life. In 41 patients more than one organism was cultured and in 11 patients the pus/medullary canal fluid did not grow any organism. Blood culture grew infective organism in 46.80% Tibia was the commonest site of infection 76/201. The incidence of chronic osteomyelitis was 2.48%, Conclusions. Even with the improvement of socioeconomic status of the community, acute osteomyelitis is still common and severe in patients with sickle cell disease. In children, the antibiotics should be aimed at the salmonella species, whereas in adults antibiotics must be given to cover other organisms; Aggressive treatment with incision, drilling of bone, drainage and antibiotics for six weeks is required to keep the incidence of chronic osteomyelitis low in these compromised patients. Copyright: King Fahd University of Petroleum & Minerals; http://www.kfupm.edu.sa

2. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. © References: ADEYOKUNNU AA, 1980, ARCH DIS CHILD, V55, P175 ALSALEM AH, 1992, INT ORTHOP, V16, P398 BARRETTCONNOR E, 1971, MEDICINE, V50, P97 CARRINGTON GL, 1925, B JOHNS HOPKINS HOSP, V36, P428 COLE WG, 1982, J BONE JOINT SURG BR, V64, P218 DIGGS LW, 1967, CLIN ORTHOP RELAT R, V52, P119 DIRSCHL DR, 1993, DRUGS, V45, P29 DIXON WJ, 1990, BMDP STAT SOFTWARE M FALTER ML, 1973, ACTA HAEMATOL, V59, P154 GELPI AP, 1970, ACTA HAEMATOL-BASEL, V43, P89 GILLESPIE WJ, 1981, J BONE JOINT SURG BR, V63, P126 GOLDING JSR, 1956, ANN R COLL SURG ENGL, V19, P296 GOLDING JSR, 1959, J BONE JOINT SURG BR, V41, P711 HODGES FJ, 1951, YB RADIOLOGY, P89 HOWARD CB, 1993, J BONE JOINT SURG BR, V75, P79 JOHNSTON RB, 1973, NEW ENGL J MED, V288, P803 KAYE D, 1967, AM J MED SCI, V254, P2015 KHAZENIFAR M, 1978, POSTGRAD MED J, V51, P541 LAMONT RL, 1987, J PEDIATR ORTHOPED, V7, P579 LEHMANN H, 1963, NATURE, V198, P492 MAH ET, 1994, J BONE JOINT SURG BR, V76, P969 MALLOUH A, 1990, 1 SCI S SOCKL CELL A, P32 MILAY SM, 1985, J TROP PEDIATRICS, V31, P292 NADE S, 1983, J BONE JOINT SURG BR, V65, P109 OKOROMA EO, 1984, CLIN PEDIATR, V23, P548 PERRINE RP, 1978, ANN INTERN MED, V88, P1 POWARS DR, 1975, SEMIN HEMATOL, V12, P267 SADATALI M, 1985, INT ORTHOP, V9, P97 SADATALI M, 1990, 1 SCI S SICKL CELL A, P34 SADATALI M, 1992, INT ORTHOP, V16, P307 SADATALI M, 1994, SICKLE CELL DIS ORTH, P55 SADATALI M, 1997, 25 ANN PED ORTH INT SCHWARTZ AM, 1972, PEDIATR RES, P145 SCOTT RJ, 1990, J PEDIATR ORTHOPED, V10, P649 VICHINSKY EP, 1980, PEDIATR CLIN N AM, V27, P429 For pre-prints please write to: abstracts@kfupm.edu.sa Copyright: King Fahd University of Petroleum & Minerals; http://www.kfupm.edu.sa